When Tony Vellucci, of Milford, lost his health insurance earlier this summer, he was anxious about being without coverage too long.

He thought about buying coverage through the state's health insurance exchange, Access Health CT, which will start enrolling people Oct. 1. However, his coverage wouldn't start until Jan. 1. What if he got sick or hurt before then? Also, the exchange is new. Could he trust it to provide him with access to the best, most affordable care?

"You can't look into a crystal ball and know what's going to happen," said Vellucci, 27.

The state exchanges are a cornerstone of the federal Affordable Care Act, which aims to provide coverage to millions of uninsured Americans, including thousands in Connecticut. Those who aren't already covered through an employer, Medicare or another mechanism are expected to use the exchange to buy care when it is officially launched next month.

But they don't necessarily have to buy through the exchange.

More Information

Get the factsTo learn more about the state's exchange, Access Health CT, visit www.accesshealthct.com or call its new call center at 855-805-4325 between 8 a.m. and 8 p.m. Monday through Friday and on Saturdays from 11 a.m. to 3 p.m.

They can buy through an insurance carrier not on the exchange. That's what Vellucci did.

Using a broker, he signed up for a plan through Aetna (an insurer that was supposed to be participating in the exchange, but dropped out in August).

Those planning not to use the exchange do so for a variety of reasons. Some, like Vellucci, might be unwilling to wait for the coverage to become available. Others might want a wider variety of plans than is offered by the exchange. And then there are those who are somewhat gun-shy.

Vellucci's quest for health coverage began in July when he turned 27 and could no longer be covered under his parents' insurance.

He is employed, at the Spooner House shelter in Shelton, but he's a part-time worker and wasn't eligible to be on the organization's insurance plan.

After losing his parents' coverage, Vellucci went on the Access Health website, and used its rate calculator option to see what he might pay for a plan on the exchange. He said, even though he was eligible for a small discount, the best rate he got was $220 a month.

But that projection was enough to get Vellucci to shop around. On a colleague's recommendation, he talked to a private insurance broker who was able to find him a plan through Aetna that was $120 a month and would start covering him in October.

Vellucci said he hasn't ruled out switching to exchange coverage at some point, but he wants to see how it develops first.

Experts said others in the state might be similarly wary for a variety of reasons. Even this close to launch, there are still many who don't fully understand the health exchanges or the Affordable Care Act, said Rachel Gaudet, a managing agent for United Insurance Group in Orange, who is licensed to sell plans both off and on the exchange.

"In talking with people, some think the ACA is an actual plan offered and insured by the federal government and that is purchased on the exchange. That is not true."

But she said even those who do understand the health care exchange might prefer to buy coverage elsewhere, because some plans offered off the exchange might be more comprehensive, with larger doctors' networks, lower drug co-pays and other attractive components. "The cons of buying on the exchange are that the plan offering will be limited in nature compared to what will be offered off the exchange directly with (insurance companies)," Gaudet said.

Exchange best option for some

But supporters of the exchange said it's still the best option for many people, mainly because it's the only avenue to subsidies, or discounts, on insurance premiums. A recent report from the nonprofit Kaiser Family Foundation looked at health exchange plans in 17 states, including Connecticut, and found that the cost of premiums dipped considerably when you factored in tax credits and other discounts.

For instance, according to the report, a single 40-year-old in Hartford would pay a premium of $232 a month for one of the exchange's lowest cost plans, but could pay as little as $97 a month for that plan after subsidies.

About 72 percent of state residents are eligible for discounted insurance, said Access Health Chief Executive Officer Kevin Counihan. Eligibility for these discounts is based largely on income.

"The key point of the exchange is that it's the only place where you can get these subsidies," he said.

Aside from lower costs, a benefit of exchange shopping many mentioned was that it will allow for easy comparison of plans. Going through a single carrier only allows you to contrast and compare their rates. The exchange allows you to scan through a variety of offerings from three different carriers -- Anthem, ConnectiCare Benefits and Healthy CT.

He said buying from an insurance carrier is like shopping for a car at a particular company's dealership, while the exchange is like using a site like CarMax that allows you to pick from a variety of options. "It's a marketplace," he said.

Indeed, though the exchange might not be for everyone, there are those, like Christina Kazanas, who see it as their best option.

Until a few years ago, Kazanas, 40, of Bridgeport, was employed with the town of Stratford. When she left to start her own business in 2010, she was allowed to remain covered through her former employer's plan, as long as she paid her own costs.

But that arrangement only lasted until this past June, and she was on her own. Kazanas said she tried to buy insurance through a private carrier and was denied coverage for a variety of reasons.

Her best option was temporary coverage through the state's high-risk insurance pool, for which she's paying $1,200 a month. Though her income makes her ineligible for a subsidy through the insurance exchange, Kazanas said the exchange plans are still much less than she's paying now.

Even better, it will likely be a long time before she has to scramble to find coverage again. When she was denied insurance "I got a taste of what millions of people go through: where your primary concern is `Oh my God -- how am I going to pay for this?' "